Anonymous
Hi,

I'm hoping you can help. I gave a male oral sex a little over 5 months ago and persuaded my local clinic to give me PEP. I finished all of the medication and received 2 negative tests. 1 at 3 months after pep and another at 4 months.
At about 5 months I got very sick and had some swollen lymph nodes in my neck that were very large, they've since gone down but are still palpable but not tender anymore.
My main concern is the possibility of the test results being inaccurate. From what I understand they were the standard 4th generation tests.

Ever since I've been battling extreme anxiety, to the point where I've had to have counselling. My hang ups are that I regularly see online that the window period after pep is 6 months, another says 3 and others just don't say anything with regards to pep.

In your expertise, would you advise that I am definitely negative, or would you suggest repeat testing? I've not had any other exposures since the one described above. In fact, I have zero sex drive, which may be a good thing for the time being.

Thank you very much in advance for your help.
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Anonymous
Hello and thank you for contacting the AIDS Vancouver Helpline. We are happy to help answer your questions.

Based on what you have disclosed, the results of your HIV test can be considered reliable and conclusive in BC. Since the BC CDC suggests that the results of an HIV test can be considered conclusive 3 months post-exposure, and this re-starts after 28-day PEP treatment, test results would be considered conclusive after a total of 112 days post-exposure:

28 days PEP treatment + 84 days after PEP treatment for conclusive results= 112 days post-exposure

Having said that, your test results would be considered conclusive in BC. However, we always suggest following HIV testing guidelines from your local region if they differ. So, it sounds like further testing is not required for this exposure unless the local healthcare professional overseeing your P.E.P. treatment believes it is necessary.

ABOUT THE 4th GENERATION EIA

* it looks for both antigens and antibodies

* antigens are detectable immediately after infection and for the first few weeks, and your HIV tests were carried out much later than this.

* people usually develop detectable antibodies as early as 21 days to 25 days post-exposure or later, and this test is reported to detect 95% of infections as early as 4 weeks to 6 weeks post-exposure. So, the results of this test 3 months AND 4 months after P.E.P. treatment can be considered conclusive in BC.

* Many HIV specialists consider the results of the 4th Generation EIA test conclusive at 6 weeks post-exposure (in your case, after P.E.P.), and this is much sooner than 3 months and 4 months after P.E.P. treatment.

Additionally, giving oral sex is considered a low-risk activity for acquiring HIV since, there have only been *a few* confirmed reports of HIV being acquired through this activity (in BC) when risk factors (e.g. another STI) are present. This activity is unlikely to transmit HIV for the following reasons:

* saliva contains a substance (enzymes) that breaks down the virus and helps stop HIV transmission from happening

* when body fluids (e.g. pre-cum, semen) are exposed to the air they can no longer transmit HIV

* the mouth/throat/stomach does not provide direct access to the bloodstream


We believe that you have received reliable and accurate test results, which indicate that the symptoms you are experiencing are not related to HIV. We may suggest that you continue to partner with your local healthcare professional to find out how else to treat the symptoms you are experiencing.

We trust we have answered your questions and thank you for contacting the AIDS Vancouver Helpline.


Sincerely,

Marta

AIDS Vancouver Volunteer

AIDS Vancouver Online Helpline

Monday to Friday 10AM to 4PM (PST)

1-604-253-0566 ext 299.

Private and Confidential


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